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Contact Information

PRABODH MISHRA
647 DULOP SUITE 200
CLARKSVILLE, TN37040
 Phone: 931-648-0064
 Fax: 931-553-4215
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PRABODH MISHRA · (Male)

NPI Number 1245681659
Status Active
Credentials
Entity Individual
Enumeration date 06/27/2016
Last updated 12/14/2022 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # LL39709
  • TN License # 65950
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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